Abstract：
OBJECTIVE: To systematically review the literature on outcomes of pelvic organ prolapse (POP) surgery in patients from various body mass index (BMI) categories to determine the association between obesity and surgical outcomes.
METHODS: PubMed, EMBASE, and Cochrane databases were searched from inception to April 12, 2022; ClinicalTrials.gov was searched in September 2022 (PROSPERO 2022 CRD42022326255). Randomized and nonrandomized studies of urogynecologic POP surgery outcomes were accepted in which categories of BMI or obesity were compared.
METHODS: In total, 9,037 abstracts were screened; 759 abstracts were identified for full-text screening, and 31 articles were accepted for inclusion and data were extracted.
RESULTS: Studies were extracted for participant information, intervention, comparator, and outcomes, including subjective outcomes, objective outcomes, and complications. Outcomes were compared among obesity categories (eg, BMI 30-34.9, 35-40, higher than 40), and meta-analysis was performed among different surgical approaches. Individual studies reported varying results as to whether obesity affects surgical outcomes. By meta-analysis, obesity (BMI 30 or higher) is associated with an increased odds of objective prolapse recurrence after vaginal prolapse repair (odds ratio [OR] 1.38, 95% CI, 1.14-1.67) and after prolapse repair from any surgical approach (OR 1.31, 95% CI, 1.12-1.53) and with complications such as mesh exposure after both vaginal and laparoscopic POP repair (OR 2.10, 95% CI, 1.01-4.39).
CONCLUSIONS: Obesity is associated with increased likelihood of prolapse recurrence and mesh complications after POP repair.
BACKGROUND: PROSPERO CRD42022326255.
METHODS: PubMed, EMBASE, and Cochrane databases were searched from inception to April 12, 2022; ClinicalTrials.gov was searched in September 2022 (PROSPERO 2022 CRD42022326255). Randomized and nonrandomized studies of urogynecologic POP surgery outcomes were accepted in which categories of BMI or obesity were compared.
METHODS: In total, 9,037 abstracts were screened; 759 abstracts were identified for full-text screening, and 31 articles were accepted for inclusion and data were extracted.
RESULTS: Studies were extracted for participant information, intervention, comparator, and outcomes, including subjective outcomes, objective outcomes, and complications. Outcomes were compared among obesity categories (eg, BMI 30-34.9, 35-40, higher than 40), and meta-analysis was performed among different surgical approaches. Individual studies reported varying results as to whether obesity affects surgical outcomes. By meta-analysis, obesity (BMI 30 or higher) is associated with an increased odds of objective prolapse recurrence after vaginal prolapse repair (odds ratio [OR] 1.38, 95% CI, 1.14-1.67) and after prolapse repair from any surgical approach (OR 1.31, 95% CI, 1.12-1.53) and with complications such as mesh exposure after both vaginal and laparoscopic POP repair (OR 2.10, 95% CI, 1.01-4.39).
CONCLUSIONS: Obesity is associated with increased likelihood of prolapse recurrence and mesh complications after POP repair.
BACKGROUND: PROSPERO CRD42022326255.
摘要：
目的：系统回顾各种体重指数（BMI）类别患者盆腔器官脱垂（POP）手术结局的文献，以确定肥胖与手术结局之间的关系。
方法：PubMed，EMBASE,和Cochrane数据库从开始到2022年4月12日进行了搜索；ClinicalTrials.gov于2022年9月进行了搜索（PROSPERO2022CRD4202236255）。接受泌尿系妇科POP手术结局的随机和非随机研究，其中比较了BMI或肥胖的类别。
方法：总共，筛选了9,037篇摘要；确定了759篇摘要用于全文筛选，31篇文章被接受纳入并提取数据。
结果：提取了参与者信息的研究，干预，比较器,和结果，包括主观结果，客观结果,和并发症。结果在肥胖类别之间进行了比较(例如，BMI30-34.9，35-40，高于40），并对不同手术入路进行荟萃分析.个别研究报告了肥胖是否影响手术结果的不同结果。通过荟萃分析，肥胖(BMI30或更高)与阴道脱垂修补术后(比值比[OR]1.38,95%CI,1.14~1.67)和任何手术方法脱垂修补术后(OR1.31,95%CI,1.12~1.53)的客观脱垂复发几率增加相关,并且与阴道和腹腔镜POP修补术后网状物暴露等并发症相关(OR2.10,95%CI,1.01~4.39).
结论：肥胖与POP修复后脱垂复发和网状并发症的可能性增加有关。
背景：PROSPEROCRD42022326255。
方法：PubMed，EMBASE,和Cochrane数据库从开始到2022年4月12日进行了搜索；ClinicalTrials.gov于2022年9月进行了搜索（PROSPERO2022CRD4202236255）。接受泌尿系妇科POP手术结局的随机和非随机研究，其中比较了BMI或肥胖的类别。
方法：总共，筛选了9,037篇摘要；确定了759篇摘要用于全文筛选，31篇文章被接受纳入并提取数据。
结果：提取了参与者信息的研究，干预，比较器,和结果，包括主观结果，客观结果,和并发症。结果在肥胖类别之间进行了比较(例如，BMI30-34.9，35-40，高于40），并对不同手术入路进行荟萃分析.个别研究报告了肥胖是否影响手术结果的不同结果。通过荟萃分析，肥胖(BMI30或更高)与阴道脱垂修补术后(比值比[OR]1.38,95%CI,1.14~1.67)和任何手术方法脱垂修补术后(OR1.31,95%CI,1.12~1.53)的客观脱垂复发几率增加相关,并且与阴道和腹腔镜POP修补术后网状物暴露等并发症相关(OR2.10,95%CI,1.01~4.39).
结论：肥胖与POP修复后脱垂复发和网状并发症的可能性增加有关。
背景：PROSPEROCRD42022326255。
